What Happens to Their Bodies?

On a Brooklyn neighborhood forum, funeral director Amy Cunningham put out the call. Could anyone contribute items, like flowers, to an upcoming funeral? An elderly woman had died of coronavirus in a nursing home and had no family in the area. Florists in New York are closed, so one resident contributed lilacs from her backyard, the Associated Pressreported. Another embroidered “Mom” on some fabric that would be placed on the casket, with the deceased woman’s family watching via livestream.

More than 16,000 people have died of Covid-19 in New York City, the epicenter of the outbreak in the U.S. Just as hospitals have struggled to keep up with the influx of sick people, the city has also struggled to accommodate all of the dead. The state has relaxed environmental regulations to allow crematoriums to operate around the clock, and the city has dispatched a fleet of mobile morgues. Burials on Hart Island, New York’s mass grave for bodies that aren’t claimed, or whose family cannot afford a funeral, have increased five-fold.

Funeral directors like Cunningham have been forced to adapt ceremonies and services around the contagious disease. Cunningham, the founder of Fitting Tribute Funeral Services, specializes in environmentally friendly burials. She and I talked about how funerals have changed in New York.

This conversation has been shortened and edited for clarity.

How is your work different since the coronavirus outbreak started in New York?

Well, my firm specialized in earth friendly burials, home funerals, and witnessed cremation services, and none of those services are currently possible in exactly the same way I was delivering them. Because of the novel coronavirus, families are saying goodbye—on a good day—with nursing assistants holding the cell phone to the ear of the dying person in a hospital that the family hasn’t even been able to enter.

I’ve got four caskets in my living room right now. That’s a little unusual.

The funerals I’m managing now involve the transporting of the deceased person in a white plastic body pouch to protect the funeral home personnel from any risk of the virus passing to them in the hours after death. That bag isn’t coming off at the funeral home. While it’s believed that the coronavirus expires within the body at the time of a death, there is said to be some risk to individuals in the hours immediately afterwards, perhaps because the lungs of the dead person still hold a bit of air, and as we move them they actually can exhale a little bit after death. Plastic body bags are a fact of life for now, but they are upsetting to me. They’re hardly eco-friendly, not remotely green. I’ve got folks looking into how we could develop something just as sturdy and kinder to the planet.

Another thing that’s different is that previously, if a death occurred on a Tuesday I could arrange for a burial or cremation two days, three days later, sometimes even the next day if the paperwork went smoothly. Because of the sheer number of dead that we’re managing, cremations are now being scheduled at the end of May.

Are there any basic things you need in order to provide your services that are either hard to get ahold of or that you’re running out of?

It seems likely that there will be a casket shortage eventually. I’ve personally solved that issue by bringing caskets into my living room at home. I live in a two-story limestone row house and I’ve got four caskets in my living room right now. I went ahead and had the casket company deliver them, and had my son and husband carry them in so that at least I’d have some caskets that were clean and ready to move when I needed them. That’s a little unusual.

Have there been an influx of families that are in need of death care services but can’t afford them? If so, what are their options?

Yes, I’m hearing from people who need a funeral, and are disappointed that the wait time for an affordable cremation is so long. Some have lost their jobs, have no money, and need to plan a funeral with a burial now that might cost $1500 to $6000. It’s pretty devastating. There was a time when the deaths were occurring so quickly that some funeral homes weren’t able to manage the sheer volume of the work and were referring people out to other firms. Those firms were helping us New York City funeral directors cremate the dead by taking them to other states. There’s so many deceased people, our crematories are overwhelmed. So, there are people driving deceased folk up to Pennsylvania, New Jersey, other areas where the crematories are a little less overwhelmed.

In the coming month, that’s going to ease up. Today in New York as you’re interviewing me, I’m not hearing the same sirens out in the streets that I was two weeks ago. So it could be correct that, as Governor Cuomo says, we’re leveling this off. But people out of work are still struggling and starting GoFundMe pages to help them with the cost of the funeral.

I will say this, however: I’m really impressed with the local funeral directors that are reducing their prices for families in that situation. How can you charge them the full rate? It just can’t happen. So, we’re offering people our services at a reduction.

What does your typical day look like right now?

The heavy lifting and placing in the casket is done by amazing folks I employ to help me at the funeral home. My day is mostly on the telephone with grieving families, trying to schedule and arrange these burials and cremations in a timely way. I’m spending a fair amount of my time explaining to families why only 10 family members can come to the cemetery. We’re trying to educate folks about the possibilities and Zoom memorials and new ways to grieve remotely so that we can have some sort of commemoration of the life as we manage the very very basic down-to-earth matter of a simple disposition right now.

What has been your advice to people who have lost family or friends to coronavirus? Either practical advice, or different advice you’re giving on how to grieve?

I had already been thinking that we place too much emphasis on the hour-long funeral service. Saying farewell to someone is really the task of a lifetime, and something that you do most intensely over the period of the first full year. So I’ve been coaching families to see that, yes, we’ve lost the gathering we’re most familiar with, but you will be able to find a way to mourn, and find community, and relate to your other family members in a way that will be new but restorative in surprising ways.

When I do have a casket in my car headed for a burial, we’ve been replacing traditional chapel gatherings with doing these outdoor block parades. I drive the car with the casket in it onto the actual block where the deceased person lived, and people can acknowledge the death as a neighborhood. I had one death caused by a heart attack. We have to remember that other sorts of deaths still occur in the age of the novel coronavirus. I drove to the man’s block, opened the car, and allowed people to approach the car while maintaining a safe distance from each other. They placed flowers in the car, and then the immediate family drove to the cemetery and stood at the lovely graveside service 6 to 10 feet apart. Good funeral, lots of love expressed.

I know you specialize in sustainable, or greener burials. Are you still able to do those kind services?

Yes. My real contribution as a funeral director in this moment is personally driving people upstate to eco-friendly cemeteries that will just bury simple caskets in the earth. The only problem is that there is this plastic body bag inside there that I never used to have to use. Most of the eco-friendly cemeteries are saying, “well, God, what can we do, we know it’s a crisis in our country, and a time of considerable suffering.” So, they may take that plastic bag for the short term as we work it out. In other words, the green burials I’m managing are just a bit less green than they used to be but we’re doing the best we can.

Do you think the pandemic will lead to any lasting changes in the funeral industry?

I hesitate before mentioning this because it doesn’t feel like a great time to criticize the conventional funeral industry. The men who have been in the business 40 years and were nearing retirement have flung themselves into this crisis and been so courageous.

However, maybe when we catch our breath, we’ll evaluate where we’re headed as an industry and how we might provide better services to more people, and take the drive to profit from the funeral out altogether by looking at cooperative funeral home structure, which is operating very successfully in the state of Washington.

In the old days prior to the Civil War, before the American funeral industry was formed, communities took care of their own. And it feels to me like we could attend to that kind of care again and find ways to make deaths less of a medical event, and more of a community-based experience. So, as I work hard and admire the conventional guys I know and work around, I’m at the same time thinking, “Gee, there must be a better way to give funeral services to people at an affordable rate, and in a loving way.”

My flustered movements alerted him to a shift in equilibrium in the house. The statewide coronavirus shutdown had just been announced, and as I struggled to wrap my head around the profound adjustments I needed to make, the fear of a grave illness was rivaled by an entirely different threat: How would I explain the crisis to my profoundly autistic 19-year-old son?

Zack’s language and comprehension are truncated; he has no conspicuous understanding of global adversity, personal sacrifice or collective safety.

The stakes of being truthful were greater than you might imagine. I’ve gone to extraordinary lengths to ensure that Zack fully participates in his community, even forcing him to remain at indoor venues he feared such as movie theaters, restaurants and airplanes. My “inclusion by fire” methods feel vindicated by the fact that Zack regularly navigates the world with competence and zeal.

But there is one dire exception — his absolute intolerance of unexpected closures. Zack has no interest in the reason: All venues should be open according to his schedule. Delivering news of a sudden closure — of a splash park shut due to lightning, a movie sold out — is perilous. In seconds, Zack lashes out in frustration. Sometimes I absorb the blows and hold my ground to enforce upon him the reality that disappointment is a part of life; more often I scramble for alternatives to distract him.

And now I couldn’t. For a young man whose life quite literally revolves around predictable schedules and recreation, virtually everything he depended upon had been eviscerated overnight.

In March, I sat Zack down and explained: “Zack, I need you to listen to me, something very scary is happening. You know how awful it feels to be sick? Well, a sickness is spreading across the whole world, and our job is to help keep people safe. So for now, school is — closed. Movies are closed. Indoor pools are ….”

I braced for impact, but instead Zack studiously began echoing the refrain of “closed.” I was astonished. In the weeks that followed, Zack’s ability to adapt to his constricted life far exceeded my expectations and reinforced my decision to tell him the truth.

Except I had not told him the whole truth. Zack had no notion that, as he rode his bike carefree against the wind, people were dying. Zack had no concept of death. Because I hadn’t summoned the courage to explain it to him.

I’ve always considered my most important job to be arming Zack with the knowledge and experience to function as competently as possible in the world, especially after my husband and I are gone. But I have not prepared him for the fact that we will be gone. As I listened to stories of beloved mothers and fathers dying, I was gripped with heartbreak and fear — would I further postpone and hope neither of us got sick?

That felt immoral. It was time.

“Zack, I need to tell you something serious,” I began. “Many people are getting sick, and some of the people who go into the hospital to get help will not get better. They will die from this sickness.” Zack is a literal thinker who deals in absolutes and concrete visuals, not abstractions. So in response to his quizzical stare, I turned on the TV to still frames I had taped of body bags being moved into a truck.

“Zack, these bodies are ….”

“Sleeping?” he asserted, tentatively.

“Broken?” he then offered, borrowing a concept he applies to objects that I’ve reassured him would soon “be fixed.” Dreading his response, I answered, “No, they are not asleep or broken, they are dead. They will not wake up. They were too sick to be fixed. They are ….”

“Closed,” he whispered gravely.

A huge exhale escaped me. “Yes, Zack, they are closed,” I said, explaining through tears that this happens to every person at some point, that their life comes to an end. And how, even when people die, as hard as it is, the rest of us have to keep living without them.

Zack became still. His countenance darkened as he processed my words — and then suddenly he lashed out. But the target was the TV, with its cruel, wintry images of death, as Zack smashed his fists into the screen and even his own head. The universe was once again disordered and the outcome unacceptable to him. I interrupted the exertion not to comfort Zack but to redirect his blows toward a wall sturdy enough to absorb them. He was incredibly infuriated, which felt entirely appropriate. More essentially, with each strike I was certain the excruciating lesson was being slowly, agonizingly absorbed.

So far, Zack has not openly made the intellectual leap that this state of permanence, which is “closing” the lives of so many right now, will one day end mine and my husband’s. That he will one day lose us, but must persist. Now is not the time to make that linkage, but it will come. Engraved into his consciousness of how the world operates is a new notion that while some closures are temporary and fixable, others are unchangeable. For now, that is enough.

A study published recently in JAMA Network highlights the need for improved pediatric advanced care for adolescents with terminal cancer. The research reveals a gap in understanding between parents and children when initiating and discussing critical conversations about end-of-life decisions.

“Teens need to have a voice in their care and families are eager to know what their teens want, but those conversations can be difficult,” says Dr. Lyon. “Advance care planning interventions for parents and adolescents create a space where they can ask questions and be honest with each other.”

While families with adolescents with cancer are often spinning with the daily struggle of life, the authors say that clinicians presume that families understand adolescents’ treatment preferences for end-of-life care – and this can cause miscommunications. As has been seen not only in the pediatric setting, a lack of advance care planning is associated with increased hospitalization, poor quality of life, and legal actions.

The study involved a survey of 80 adolescent-family dyads (160 participants) from four tertiary care U.S. pediatric hospitals. From July 16, 2016, to April 30, 2019, the families were exposed to Family-Centered Pediatric Advance Care Planning for Teens With Cancer intervention sessions.

The results showed that family members’ understanding of their adolescent’s beliefs about the best time talk about end-of-life decisions was poor, with 86% of adolescents desiring an early conversation on the topic (before getting sick, while healthy, when first diagnosed, when first sick from a life-threatening illness, or all of the above), but with only 39% of families understanding this. This was particularly when it came to the topics of dying a natural death and being off life-support machines. Nevertheless, families’ did seem to have an excellent understanding of what was important to their adolescents in regards to wanting honest answers from their physician and understanding treatment choices.

The findings from the study can be found here in the article “Congruence Gaps Between Adolescents With Cancer and Their Families Regarding Values, Goals, and Beliefs About End-of-Life Care.”

Jonny Kennedy is a man with a lot to do. He’s got just four months to move home, meet Nell McAndrew, fly a plane, visit Downing Street… and plan his own funeral.

I Hope Doctors and Nurses Will, Too.

Bodies being moved into a refrigerated truck outside of Wyckoff Heights Medical Center in Brooklyn, in April.

A lesson from hospice care might help.

By Theresa Brown

Nurses crying. That’s what I hear from the front lines treating Covid-19 patients. A nurse will begin the shift crying and end it crying. Crying. And we are not a profession that cries easily.

“Untenable” is how the sister of Dr. Lorna Breen, a physician in New York who died by suicide in late April, described her sister’s work situation. She was right. In hospitals with Covid-19 patients, understaffed clinicians often lack sufficient personal protective equipment and tests for the virus, and they fear for their own lives. These conditions would wear on anyone. But they amount to a staggering burden for doctors, nurses and health workers of all kinds whose deeply ingrained duty is to save the lives of their patients.

These medical workers remain devoted to curing and easing the pain of the desperately ill. But what can be done about their pain? Their feelings of failure? Frontline clinicians all over the country are experiencing anxiety, insomnia, a sense of acute inadequacy, and feelings of being betrayed by hospital administrators. Many will likely end up with PTSD. Helplessly watching so many people die, especially when many of them die without their loved ones present, is professionally “untenable.”

We know there is no universally effective treatment for the sickest Covid-19 patients. But their deaths are clearly not the fault of their caregivers. Is it possible to ease clinicians’ burdens so that they feel less personally responsible when these patients die? I believe that another type of care situation, that of a hospice, may offer some lessons.

The most fragile Covid-19 patients are not unlike hospice patients: There is no cure for their condition. While they differ from hospice patients — their deaths often come on suddenly and cannot be foreseen — clinicians might more easily make peace with their deaths by viewing them through a hospice lens.

Even though we are all going to die, death fits uneasily into the world of health care. Fundamentally, health and healing apply to the living, not the dying or the dead, and helping the living get better is why most nurses and doctors got into this work. When I worked in oncology, I saw this principle acted out by physicians who viewed death as failure, and nurses who equated talking honestly about bad prognoses with destroying patients’ hope.

Hospice care approaches death very differently. Practicing as a nurse in home hospice, I understood that patients were going to die. The goal was for them to have the best life possible for as long as possible and to die with minimal distress. Some people associate hospice with “giving up” on dying patients, but that is mistaken. Hospice staff do not hurry death along. Rather, hospice clinicians concede that curative treatment either does not exist for, or has been declined by, the patient, and accept that patients will die under hospice care.

As a hospice nurse, I managed symptoms — pain, trouble breathing, delirium — treated wounds, listened to stories from the past and acknowledged hopes and fears for the future. My intention was that all of my patients would leave this earth without suffering, and though that wasn’t always possible, I tried.

People often say that hospice nurses are angels. I tended to demur and say, “Nope, I’m human.” What the praise shows, I think, is that being comfortable with death is unusual. “Comfortable” is the wrong word: I accept death. I accept its inevitability, but also its importance. Death is the end of each person’s time on earth; it is a privilege to care for people in that moment. I embrace the cycle of life while recognizing the sadness of every death.

(That acceptance is somewhat conditional, though. Two and a half years ago, when I was diagnosed with breast cancer, I chose to take a leave from hospice work. My diagnosis brought the cycle of life a little too close.)

What’s more, a century ago, all of us would have been much more familiar with death than we are now. There were no high-tech emergency departments or I.C.U.s; most people died at home. Modernity made it possible to hide death in hospitals, behind beeping machines and snaking tubes and wires. But now that the entire world is threatened by a previously unknown virus, death has once again come closer.

I am not suggesting that health care workers become indifferent to Covid-19 deaths, or that a certain amount of death from this disease should be callously dismissed as inevitable. No. Instead, I’m urging nurses and doctors to feel less overtly responsible when Covid-19 patients die. As a hospice nurse, I never experienced a patient’s death as failure. Some deaths seemed unjust in a universal sense, like a young mother succumbing to cancer or a dying patient saying she was denied the full scope of cancer treatments because she was black. But the trajectory toward death — I accepted it.

When a patient dies on home hospice, a hospice nurse legally pronounces the death by calling the medical examiner and getting the body released. At pronouncements I did the required paperwork, and I also helped hold, or emotionally contain, the death for everyone gathered. I witnessed the ending of a cherished life and honored loved ones’ grief.

Hospital staff caring for Covid-19 patients need someone to help them hold all the deaths. It is too much to feel responsible for so many imperiled lives, day after day, to rub up against one of the most challenging and often unacknowledged paradoxes of modern health care: Even though we work very hard to heal people, sometimes they still die.

It might be possible to plant a hospice nurse in every Covid-19 I.C.U., but frontline clinicians can also do the work of acceptance by admitting that despite their training, intelligence, tenacity and technology, patients will continue to die of Covid-19. That fact is tragic, and knowing that the mortality rate has been compounded by the failings of our health care system doesn’t help. But it is still possible that the sum of human suffering in this situation can be lessened if nurses and doctors put the blame for their patients’ deaths where they belong — on the virus, not on themselves.

COVID-19 patients are dying alone. Is there any way to make their experience—and that of their loved ones—less horrifying?

Visitors are typically restricted, which means that family members of some coronavirus patients are prohibited from being with them in their last days, unable to touch or hold their loved ones. This scenario is only expected to get worse. According to the Institute for Health Metrics at the University of Washington, as many as 82,000 people in the United States could die from the contagion, while other models show up to 125,000 people. Many health facilities—from traditional hospitals to makeshift alternative care sites—will have to decide how best to provide dignified end-of-life care to COVID-19 patients and their loved ones.

The two of us have collectively worked in healthcare architecture and research for more than 30 years and have worked nationally and internationally on palliative care solutions in a variety of healthcare settings. We also both recently lost loved ones. We know firsthand how important compassionate end-of-life care is. Yet existing guidelines from Centers for Disease Control on alternative care sites—the very places many acute COVID-19 patients are dying—do little to address it. Here’s how traditional and nontraditional care spaces alike can create safe, comfortable end-of-life experiences, even when resources are stretched thin.

A comfortable environment

Support privacy

Having a degree of privacy is crucial so that each patient can say goodbye to loved ones or have religious rites. This can be done in-person or, more likely these days, virtually. (Some facilities do allow a visitor for end-of-life cases, with the provision that visitors wear personal protective equipment.) Normally, patients get a private room, but many hospitals are overrun and simply don’t have the space. Instead, hospitals and makeshift medical facilities could provide a simple curtain or a divider between beds.

Family visits

Establishing protocols for visits is important, so patients and family alike know what to expect. Facilities should clearly communicate whether visitors are allowed in person or virtually, what visiting hours are, how many visitors are allowed, and what sort of screening they need to pass. There should also be clear direction around mementos or spiritual items that family may want to pass to their loved one: Are they allowed or not? How should they be handled?

Support two-way communication

If family members are not allowed to visit physically, care centers can support other ways loved ones can say last goodbyes, such as two-way video communication, or visual contact through a protective barrier, like a window.

Positive distraction

Personalized acoustics or comforting nature sounds can go a long way toward making a patient feel comfortable. Many of the makeshift hospitals that have been built to support COVID-19 patients are bare bones and don’t support elaborate sound systems. But headphones or bed speakers can work just as well. When patients are conscious, access to sunlight, nature, or images of nature can also be soothing.

Hospice caregivers

Dedicated hospice workers can manage the caring aspect of end-of-life care when resources across the system are under siege. Staff qualified to tend to very sick patients should remain in those designated areas.

How to create a safe environment

Building dignity into end-of-life care is only part of the solution. Care facilities also have an imperative to prevent spreading the virus further. Here are some key considerations.

Medication access

Narcotic drugs should be securely stored but located so caregivers can reach them easily. The medication may be placed in a locked cabinet at a designated staff workstation near patient care areas, for instance.

Dedicated entry

For facilities that allow family members to say their final goodbyes in person, providing a dedicated entry to the space can reduce the chance of transmission. Mobile handwashing stations can also be provided throughout the facility. Donning and doffing zones should be established for any staff and family members entering or exiting the facility.

Staff accommodations

Dedicated toilet rooms and respite areas can be provided for healthcare workers. The death of a patient can be difficult for even the most experienced caregivers and they, too, need space to process their pain.

Back-of-house access

When patients die, they should be removed discreetly from the facility, through a separate exit. This is not only to preserve their dignity and avoid frightening visitors and other patients. It’s the safest approach to prevent spreading the coronavirus.

None of these are new ideas in healthcare design, but as hospitals rush to treat legions of new COVID 19 patients, they have to embrace the reality that many patients will succumb to the virus and their families will suffer. There are ways to help ease that suffering in a compassionate way.

During this pandemic when we’re feeling the anxieties of infection and death, The Death of Evan Ilyich (1886), by Leo Tolstoy gives us the message of our capacities to respond to the fear of death in ways we never knew we could. It reminds us that, fear isn’t real. Human, as a species, is not defined by fear.

YES, we’re scared. We’re on the edge, unable to think properly. Our focus flutters and floats around flea-like from one update to the next. We follow the news, because we feel we should but soon we wish we hadn’t, because it’s sad.

The thought of dying alone with a respiratory sickness is so horrifying to hide under our masks. We are separated from one another but we can’t keep our distance from the fear of death. This led me to question, how can I accept my own mortality, so that I can live my life to the fullest during this terrifying situation?

Then I found a novella The Death of Evan Ilyich (1886), by Leo Tolstoy which helped me not only to understand the author’s philosophy towards death but also the psychology behind it. As a result, I could gather some emotional courage to embrace my fear of death during this COVID-19 pandemic situation.

Leo Tolstoy (1828-1910), a Russian writer, is regarded as one of the greatest authors of all time. He is best known for his novels like War and Peace (1869) and Anna Karenina (1877). But due to his unusual firsthand experiences of death and dying, he also wrote extensively about the inevitability of death for our understanding of life itself. Some of his most memorable meditations on this theme are found in his novella The Death of Ivan Ilyich. In the novella through the story of a dying Russian judge, Tolstoy successfully narrates the different episodes of ‘dying’ some eighty years before its discovery by Swiss-American psychiatrist Elizabeth Kubler Ross. In her book On Death and Dying (1969) Kubler Ross outlined five stages that a dying individual goes through.

The Death of Ivan Ilyich, as its title suggests, depicts the death of an ordinary middle-aged Russian judge, but it is also about a man who overcame it. Like everyone in his social circle, Ivan Ilyich lives a superficial life and dedicates his life to climbing the social ladder and seeking the bliss which he believes is found at the top. Initially he was contented with his life but gradually he becomes unhappy as his marriage deteriorates so he starts ignoring his family life and focuses on becoming a magistrate.

One day he falls awkwardly upon hanging curtains for his new home and becomes ill. Doctors offer all kinds of diagnoses and medicines but he cannot recover and within some weeks, Ivan Ilyich could see that he is a bedridden dying man. In his death bed Ivan’s main source of comfort becomes his servant Gerasim. He is the only person in the house who does not fear death, and the only one other than his own son who seems to show compassion for him.

As Ivan’s interaction with Gerasim becomes deeper, Ivan begins to question the how can he accept death without being unhappy? Gerasim guides Ivan in his last days, and allowed him to realise the difference between a superficial and an authentic life and how to accept death with ease. He says, ‘We shall all of us die, so why should I grudge a little trouble?’ Apart from the philosophical thought, Tolstoy also shows the psychological stages of a dying person.

According to Ross, denial is the initial emotional response to the knowledge of death. In this stage people often say, ‘No, not me. It can’t be!’ From chapter five we find Ivan Ilych gets the idea that he is going to die but he could not get used to the idea and immediately denies it. In chapter six he says, ‘It can’t be me having to die. That would be too horrible.’ After a while, he entered the stage of anger, blaming god for imposing this kind of misery and pain to him, and expecting an answer, ‘Why hast Thou done all this? Why hast Thou brought me here? Why, why dost Thou torment me so terribly?’

Then he started talking to god asking for the meaning of his life. During this ‘bargaining’ period he started to look back and after much argumentation with himself he realises that he may not have done anything meaningful during his whole life. Consequently he enters into the ‘black hole’ of depression. He learns that it is impossible to turn back and fight against the forces, now he can only wait for the moment.

Finally, the door of acceptance was opening in his scared mind, with his understanding of the inevitability of death. Ivan Ilyich during this stage realises that he has not lived his life in the best way and he was dead long before he was called to die. He was materialistically driven and blinded most of his life by shallow pleasures. He eventually finds solace from the selfless love and kindness from his family and servants and embraces death. ‘Death is finished,’ he said to himself. ‘It is no more!’

Therefore, The Death of Ivan Ilych is Tolstoy’s parable representing the mystery that living well is the best way to die well. Tolstoy tells us that we don’t fear death, we fear life because we feel that we don’t live our destined time on earth as we were supposed to. It also echoes with the Stoic philosopher Marcus Aurelius who told us that ‘it is not death that a man should fear, but he should fear never beginning to live’.

During this pandemic when we’re feeling the anxieties of infection and death, this story gives us the message of our capacities to respond to the fear of death in ways we never knew we could. It reminds us that, fear isn’t real. It is like wearing the uncomfortable personal protective suit around our mind and feeling we’re being protected.

In doing so, we have allowed this fear into our house, our head, and our heart. It’s circulating like the ghostly virus — looking for prey in every thought and every action. But we must remember that human is not defined by fear. We are a hope and a faith-driven species that seeks to live life to the fullest and not die.